The Tooth Fairy—Or Big Brother?

Add this to Iowa’s back-to-school checklist for incoming 1st graders and high school freshmen: mandatory dental screenings.

Eager to raise public awareness about oral health, state officials are pleased with a new law that goes into effect July 1, 2008, requiring such screenings, which are less extensive than full dental exams.

“We want to alert and sensitize parents to the fact that oral health is important,” said Bob D. Russell, the dental director of the Iowa Department of Public Health, from which the bill originated.

The bill mandates that the health department come up with a formal definition of a screening, which Dr. Russell described as “a visual observation for any obvious signs of decay” or any other serious problems. The screening can be performed by a dentist, dental hygienist, physician, or nurse, according to the text of the bill, which does not mandate any treatment.

Dr. Russell, a dentist, likened dental screenings to physicals for student-athletes. He said that awareness of the dangers of poor oral health was raised earlier this year when a 12-year-old Maryland boy died after a bacterial infection in a tooth spread to his brain.

But some opponents worry about the financial strain it will cause for families unable to pay for a screening. The legislature put no money behind the bill. Mr. Russell said a screening typically would cost far less than a dental exam—probably under $25.

Sen. James Hahn, a Republican, said that while he is a strong believer in the importance of dental hygiene, he voted against the bill because of the lack of funding.

“I have some concerns about the cost, and about people who don’t have coverage,” he said.

Several other states, including California and Illinois, have similar dental-screening mandates for students.

Dr. Russell said that the health department is working on programs to help those who cannot afford the screenings, but stressed that a screening does not require any treatment.

But an editorial in The Des Moines Register criticized the lack of funding for follow-up care.

“Iowa lawmakers who saw fit to require Iowa parents to get a kid’s mouth looked at also should raise [Medicaid] reimbursement rates to pay dentists enough to cover the cost of treating those children,” read the newspaper’s May 11 editorial.

See Also

See other stories on education issues in Iowa. See data on Iowa's public school system.